右美托咪啶对气管插管期心血管应激反应的影响  

Effects of dexmedetomidine on cardiovascular stress response in tracheal intubation under general anesthesia

作　　者：史创国 薛荣亮[1] 

机构地区：[1]西安交通大学第二附属医院麻醉科,陕西西安710004 [2]西安航天总医院

出　　处：《中国现代医药杂志》2018年第1期18-21,共4页Modern Medicine Journal of China

摘　　要：目的观察右美托咪啶(Dexmedetomidine,DXM)预防全麻气管插管期心血管应激反应的效果。方法选择拟在全身麻醉下择期行腹腔镜胆囊切除手术患者50例,ASAⅠ~Ⅱ级,随机分为对照组和观察组(n=25)。对照组麻醉诱导前静脉输注等剂量生理盐水,观察组麻醉诱导前静脉输注右美托咪啶(初始剂量1.0μg/kg,输注10min)。麻醉诱导后行气管插管机械通气。记录入室后(T_0)、气管插管前(T_1)和气管插管后即刻(T_2)血压(MAP)、心率(HR)和T_0与T_2时刻的血糖浓度。结果与T0比较,气管插管前两组MAP均降低,差异有统计学意义(P<0.05或P<0.01);与对照组比较,观察组MAP下降幅度明显减小,差异有统计学意义(P<0.01);对照组与观察组比较HR明显降低,差异有统计学意义(P<0.01)。与T0比较,气管插管后对照组MAP、HR和血糖浓度均明显升高,差异有统计学意义(P<0.01或P<0.05);观察组MAP、HR和血糖浓度无明显升高,差异无统计学意义(P>0.05);与对照组比较,观察组MAP、HR和血糖浓度变化幅度差异有统计学意义(P<0.05)。结论右美托咪啶可减轻全身麻醉诱导后血压的过度降低,降低气管插管时的心血管应激反应,维持稳定的血流动力学。Objective To observe the effects of dexmedetomidine（DXM）on cardiovascular stress response in tracheal intubation. Methods Fifty ASA Ⅰ-Ⅱ patients scheduled for laparoscopic cholecystectomy were randommized into control group treated with normal saline and observation group with DXM. In observation group,before induction of anesthesia,1.0μg/kg of DXM were continuously pumped 10 min.Patients of control group were continuously infused saline as controls. After anesthesia induction,the patients were mechanically ventilated.Mean artery pressure（MAP）and heart rate（HR） were recorded before infusion of dexmedetomidine（T0）,before intubation（T1）,immediately after intubation（T2）and the blood glucose concentration（GLU）at T0 and T2 moments. Results Before intubation of anesthesia,comparing with T0,MAP at T1 decreased significantly in two groups（P 0.01 or P 0.05）.Intergroup comparison showed that observation group was notably higher than control group in MAP at T1（P〈0.01） and control group was notably higher than observation group in HR at T1（P〈0.01）. After intubation of anesthesia,comparing with T0,MAP,HR and GLU significantly increased at T2 in control group（P〈0.01 or P〈0.05）. MAP,HR and GLU didn＇t increase at T2 in observation group（P〈0.05）. Intergroup comparison showed that control group were notably higher than observation group in MAP,HR and GLU at T2（P〈0.01 or P〈0.05）. Conclusion DXM is beneficial to stabilizing the haemodynamics and reducing the cardiovascular response to endotracheal intubation under general anesthesia.

关 键 词：右美托咪啶 气管插管 心血管 应激反应 

分 类 号：R614[医药卫生—麻醉学]